Individual
EDITH LORENA URIBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8381 LA PALMA AVE, BUENA PARK, CA 90620-3271
(714) 228-9990
Mailing address
86 DEERFIELD AVE, IRVINE, CA 92606-7617
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D2138536
DRIVER LISCENSE
CA
Enumeration date
02/04/2011
Last updated
02/04/2011
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